AB1627 DYNAMICS OF IMMUNOLOGICAL PARAMETERS IN PATIENTS WITH SLE DURING THE YEAR AFTER VACCINATION WITH 23-VALENT POLYSACCHARIDE PNEUMOCOCCAL VACCINE
Authors: G. Koilubaeva, G. Tarasova, B. Belov, A. Bolotbekova, A. Turatbekova, G. Syunbai K
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pneumococcal vaccination in systemic lupus erythematosus (SLE) is designed to reduce the risk of severe respiratory infections in this group of patients. The issues of vaccination safety remain relevant. <h3>Objectives</h3> to study the dynamics of immunological parameters in patients with SLE during the year after vaccination with 23-valent polysaccharide pneumococcal vaccine (PPV-23), their correlation with the clinical picture of the disease. <h3>Methods</h3> 78 patients with SLE were included in the study. 4 patients received monotherapy (GC-1, methotrexate-1, GC-1, anti-B-cell therapy-1), the rest received combination therapy, including 29 - anti-B-cell therapy. 3 groups of patients were identified for analysis: 1. patients (36) who received stable doses of immunosuppressive drugs. 2. patients (31) who had their medication doses reduced during the year. 3. patients (11) who received increased doses of medications during the year. The follow-up period was 12 months after vaccination. <h3>Results</h3> During the observation period, no new autoimmune phenomena, both clinical and laboratory, were recorded. Stable therapy group: in the first 1-3 months after vaccination, 4 out of 36 patients had a transient increase in a-DNA without an increase in ANF and without signs of exacerbation of the disease. Another 4 had an increase in ANF (1 had a transient increase), without an increase in a-DNA and without signs of deterioration. By 12 months, there was an increase in a-DNA in 4 and ANF in 5 patients. Moderate exacerbation of the disease was recorded in 3 patients (after 3.5 months, 5 months, 12 months): in the first case, persistently high immunological activity and clearly insufficient therapy were observed; in the second case, the exacerbation was not accompanied by an increase in immunological activity at all; in the third case, the exacerbation occurred after 12 months with a moderate increase in immunological activity indicators. In all cases, the association with vaccination has not been verified. The group on the reduction of doses of therapy: 5 cases of a significant increase in a-DNA after 1-3 months were recorded: in 4-transient, in 1-with a transient increase in ANF, in all without signs of exacerbation. Moderate exacerbation was observed in 4 patients (after 4 months, 11.5 months, 12 months, 12 months), in 2 – without an increase in immunological activity, in 2 – with an increase in a-DNA and ANF by 11-12 months. The timing of the exacerbation, the cancellation of cytostatics in one case and a reduction in the dose of glucocorticoids in 3 cases did not allow the exacerbation to be associated with vaccination. Group of patients with increased therapy: no cases of significant increase in a-DNA, ANF, exacerbation of the disease was detected. <h3>Conclusion</h3> 1. The multidirectional dynamics of the main immunological markers observed during the year most likely reflects the immunological instability characteristic of SLE. 2. In the first 3 months after vaccination, in isolated cases, a transient increase in SLE markers is possible without symptoms of exacerbation of the disease. 3. During the year, there were no exacerbations significantly associated with vaccination. 4.There is no need for mandatory immunological monitoring 1-3 months after vaccination, clinical monitoring is necessary. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.